Staying Well: Strategies for living and working well with mental illness

Sarah Russell
We asked researcher, author and former nurse Sarah Russell to share her strategies for staying well with a mental illness.

Sarah has also written about her personal journey to embrace life with bipolar disorder — check out The Stay-Well Plan: My Life with Mental Illness.


friends at beach


Mental illness is not a character flaw, personality trait or sign of personal weakness. It is an illness that can affect anyone, regardless of age, race, social class or sporting ability. Those of us who have a mental illness can find it hard to accept, but it is essential if we want to stay well.

Many people who have bipolar disorder describe the importance of being mindful of their condition. Although many of us would undoubtedly like to forget about our illness, we benefit from maintaining an awareness of its presence. This helps us to stay well.

Although there is not a “one-fix-fixes all” approach to staying well with mental illness, my research and personal experience has identified some common themes and interventions.


The first step to wellness is to be given the correct diagnosis. I was lucky — I received the correct diagnosis after my first episode of mania. For others, it may take several years to be diagnosed correctly.

After receiving the correct diagnosis, the next step is to accept the diagnosis. When people accept their illness and learn about it, they are often able to take more control of their lives.


It’s important to learn about your mental illness and embrace self-knowledge. An important source of knowledge is life experience, including episodes of illness. Each episode of illness is an opportunity to learn more about your triggers and early warning signs.


Sleep is a crucial ingredient to staying well. I talked to my doctor about what to do if I wake up during the night, buzzing with ideas or thinking about something stressful, and now I know that what works for me is to take a prescribed sleeping tablet. Talk to your doctor about what might work for you.

Managing stress

When I worked as a nurse in ICU, every day was stressful. Everyone has different strategies to minimise the impact of stress. Strategies may include regular holidays, shiatsu massages, yoga, meditation, exercise, counselling, friends and so on. My stress management strategies included riding my bike to and from the hospital, talking and laughing with colleagues. However, these ‘wind down’ strategies did not always work. It was sometimes necessary for me to alter medication during particularly stressful periods.


Fact sheets inform people with mental illness about the benefits of having a healthy lifestyle — diet, exercise etc. However, there are times when these healthy activities are much easier said than done. When I am feeling down, for example, I just want to lie around, eat junk food and drink alcohol. I also want to socially isolate myself. My Stay-Well Plan allows me to hibernate on the couch with corn chips and beer for two days. On the third day, I must get off the couch, go for a walk and socialise (without alcohol!). I also ride my bike to work — rain, hail or shine.


It is important to be aware of triggers and mood states. With awareness, I am able to stay in control of my moods by implementing stay-well strategies when I experience a trigger (e.g. stress at work, jet lag) and early warning signs (e.g. difficulty sleeping, talking fast).


A number of factors may trigger an episode of bipolar disorder. These include fatigue, jet lag, hormonal fluctuations, change of seasons, all night partying and recreational drugs. However, the most common triggers are stress and sleep deprivation. The relationship between these two triggers is complex. In some cases stress causes disruption to sleep. In other cases, a lack of sleep causes a low resilience to stress. Either way, those of us with bipolar disorder must be quick to implement our stay-well interventions when we have difficulty sleeping, waking up in middle of night with our thoughts buzzing.


Stay-well interventions may involve cancelling a few social engagements, getting a few good sleeps, meditation, increasing medication, yoga or making an appointment with a health care professional. With experience, people learn how to respond to warning signals to ensure they avoid episodes of illness. I am lucky because I have a beach shack to which I escape. I also have friends who understand if I must cancel a social engagement.


Although staying well is rarely just about taking prescribed medication, medication is an important component of many stay-well plans. More precisely: the right medication at the right dose. I take medication without fail — no ifs, no buts, even if I’m feeling good. I also have regular blood tests.

Supportive workplaces

Stay-well strategies work best when there is a sensitive and aware work environment. Also, after an episode of illness, an understanding and supportive workplace can assist a person in their transition back to daily life. If you feel your workplace could be doing more to support you, call Nurse & Midwife Support on 1800 667 877 to discuss your potential options.

Social support

Partners, parents, children, brothers, sisters, friends and colleagues gain insight into the expression of our disorder. This ‘outside insight’ often helps us to manage our illness. Many years ago, I established a ‘Stay-Well Committee’ with close friends. If they see me talking more quickly than normal or obsessed with an issue, they tell me that they don’t think I’m OK. I trust their judgement and immediately intervene. This committee is my safety net.

Professional support

People with mental illness benefit from relationships with professionals that are based on mutual respect. However, the quality of professional psychiatric support varies enormously. It is worth shopping around to find a doctor who understands the principles of patient-centred care (i.e. psychiatrist and patient working in partnership).

Mental illness can present differently even amongst people who share a disorder, so your solutions might be different from Sarah’s. If you’ve found your own strategies to handle a mental illness or you would like some more ideas to help you live and work well, we’d love to hear from you: call Nurse & Midwife Support on 1800 667 877 or get in touch by email!;